Coronavirus in Context: A View from Australia on Mental Health

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You're watching Coronavirus in Context. I'm Dr. John Whyte, chief medical officer at WebMD. COVID-19 is a pandemic, meaning that it's impacting people all over the world. And many of my episodes have focused on what's happening in the United States.

But today, I want to spend some time talking about what's happening in other countries, specifically Australia. So I've asked Dr. Kieran Kennedy, a physician from Australia, to join me. Dr. Kennedy, thanks for taking time.

Yes, good morning, John. Thanks so much for having me and for a bridging the time gap here. I'm keeping you up late over there, maybe.

Yes, yes. Let's start off with what's happening with respect to COVID in Australia and your neighbor, New Zealand?

Yeah. And I think in Australia and New Zealand, we're a little bit lucky in a sense in terms of we're slightly geographically isolated over here. And so I think compared to other areas of the world, we've really been quite lucky to not be hit as hard with COVID-19 as other areas.

But it's still been a real concern. And obviously, there's been significant lock down and restrictions over here. But at the moment, things are looking quite good. So New Zealand has one active case for the whole country. And Australia has, as of the last check, 18 patients in hospital that are positive.

But we're really sort of moving through completely sort of flattening the curve and just monitoring things. So it's been a wild ride and a scary time here, as for the rest of the world. But lockdown and restrictions are really starting to ease, and so it's an interesting time where we're sort of coming back out into the new normal in a way.

You and I talked about prior today-- and you have this interest in mental health and wellness. And you brought up this issue of rebound anxiety. Not the anxiety of people being home in lockdown, as many people are in the United States, but more so the anxiety as things start to open up. And you've seen more of that than we have here. Tell us what you mean by that, and what's going on.

Yeah. I'm really humbled to sort of be speaking with you about this today, John, because I think this is something that we're going to see more of as the world comes through the initial crisis point of the pandemic. And obviously, mental health issues during lockdown when things first really hit have significantly risen. So rates of anxiety, low mood, adjustment-related mental health disorders have skyrocketed.

But what we're starting to see here in Australia and New Zealand now, interestingly, is, as you say, a bit of a second wave or a rebound on the mental health side as well. And I think as we're kind of coming out of what we've adjusted to in terms of staying home, restricting ourselves socially, doing all the things we needed to do to ensure COVID-19 sort of was completely flattened, as we're sort of coming back out into the world and adjusting to the new normal, I'm seeing a lot of people in clinical practice, but also statistically over here, we're starting to see that people are really getting a bit of a rebound anxiety around that as well.

So that's going to be something we're going to have to really be aware of, I, think as mental health professionals and as physicians when it comes to things getting much better on the COVID-19 transmission right front. But actually, as our minds learn to adjust to what the world is now like around us and as we come out of our homes, in a way. Because we had a new normal of lockdown. And now, we have the new, new normal. And everyone isn't necessarily ready to go back in to society and resume some of those activities. We also talked about the differences in the way men and women may present in terms of some of the mental health issues that you're seeing. Talk to us about what those differences are.

Yeah, this is something that I'm quite passionate about. Men's mental health is a really interesting area to work in because globally, mental health is an epidemic, and something that is really hitting the charts in terms of our rates of chronic disability, our rates of chronic illness. But sort of for men particularly, there is still such a significant stigma around opening up about struggling with mental health, seeking professional help for mental health issues.

And that's reflected in some of the statistics. So worldwide, rates of suicide in young men, for example, are significant. And we're still saying in statistics and studies that men are presenting for help with mental health issues significantly less than women.

Mental illness doesn't discriminate by sex or gender, but how it is expressed and showing is impacted by those things. So some of the structures around masculinity and concepts of who a modern man needs to be and how a modern man should act are still often holding men back from showing that they're really struggling.

So I think for men in particular, they are more likely to withdraw when they're experiencing anxiety and depression. We know that rights of men using alcohol or substances to maybe avoid or cover over struggling with mental health issues are higher.

I think for everyone, it's really important that we push back on this stigma around mental health and needing help from mental health. But particularly for men, it's something that we need to really call out and say it does not make you any less of a man. It's nothing to do with your masculinity if you are struggling at the moment and you need help.

So we've talked about the role of psychiatrists and mental health professionals in addressing some of these anxiety, depression, and other issues relating to COVID. But you and I also talked about other measures that are important in terms of one's overall wellness in terms of sleep and activity and exercise. And I don't want to embarrass you, but you were on the cover of Men's Health Australia. Is that right?

That is right. And hopefully, my cheeks don't go too rosy with you bringing that up.

Tell us what, first of all, what you do to maintain mental health and resilience and what others can do during these stressful times.

There are little basics every day and very practical things we can put in place to be helping with our mental health. One of those is-- and you won't be surprised at all that I'm going to say this, John, but exercise and fitness is something that we know more and more can positively impact our mental health. So I've been encouraging people to get some form of daily activity in every day and scheduling that in. And research shows that for mild anxiety and depression, that can be just as effective as an antidepressant. So routine and scheduling things there's a really good practical tip for people as well.

Sleep is a biggie, and something that I'm personally and professionally pretty passionate about. But sleep we know has a significant impact on how we're doing mentally. And it can act as a helpful factor for if we're experiencing mental health struggles at the moment. But it also acts as a resiliency and a protective factor to go to bed at the same time each night.

And most people should be aiming for seven to eight hours of sleep. Some people will need slightly more. Some people slightly less. But that's a good sort of grounding to go off. And I've been talking to people a lot about some very practical, basic sleep hygiene tips as well.

I think particularly with working from home-- and I'm a bit guilty of this, too-- we've been slipping into maybe using the laptop and phone in the bedroom and the bed, when really, our bed should be in particular just for sleep. So we need our brain to associate going to bed with going to sleep.

Other things-- reducing the bright lights from screens and laptops in the hour before bed. And also, trying to reduce caffeine in the second half of the day. And that is obviously through coffee, but also pre-workout. Dark chocolate can have a certain amount of caffeine in it.

Now, come on, Dr. Kennedy. Don't take away the dark chocolate.

We'll let that one slide.

All right, we'll let that one slide if it's just a little square. Now, are you hopeful that if we institute some of these measures for resilience that we can end the growing epidemic of mental health issues that we're in the middle of?

I am hopeful. And I think just taking these type of acknowledgments on board in terms of actually needing to actively think about out thinking and feel what we're feeling right now as being most important-- I am really hopeful we can stem things.

Another really sort of promising and inspiring thing, particularly here in Australia and New Zealand, has been seeing the acknowledgment of mental health being on par with our physical health right now. And so there's been campaigns in terms of making people more aware of what they're mental health is doing right now, and specific COVID-19-related avenues for people to get support if they're experiencing anxiety, low mood, struggles with their mental health as we move through the pandemic and now as we're coming out of it into the new normal as well.

We started off by talking about how Australia and New Zealand have been able to flatten the curve. And in the last couple of minutes, what other tips do you have for the folks in the United States to flatten the curve, as Australia and New Zealand has done?

There's really been a community sense over here of people really getting on board with social distancing recommendations and things. And something I'm quite passionate about as well is directing people maybe away from some of the misinformation and myths that are floating around on social media and online and encouraging people to, I guess, look at what their local area or state is recommending in terms of social distancing restrictions, and really just adhering to those as a way to look after not just ourselves, but everyone, and get us flattening this curve, and hopefully at the same time, looking after our mental health, too.

And Doctor Kennedy, I want to thank you for taking time today to share your insights.

Thank you so much, John. It's been an absolute pleasure.

And thank you for watching Coronavirus in Context.